Second scabies outbreak at Bergen Regional Medical Center

Bergen Regional Medical Center has had a second scabies outbreak, part of a statewide uptick in cases of a highly contagious rash that can be particularly vexing in nursing home and institutional settings, officials confirmed this week.

Five patients at the Paramus facility – including three residents of its 574-bed nursing home unit – were diagnosed earlier this year with scabies, an itchy skin condition caused by tiny mites that burrow into the outer layers of the skin. The other two afflicted patients resided in the hospital’s behavioral health unit, Bergen Regional spokeswoman Donnalee Corrieri confirmed this week.

The five cases, the last of which was considered cleared up by last month, are believed to be unrelated to a prior outbreak in the summer of 2012, when seven long-term-care patients received confirmed scabies diagnoses, Corrieri said.

In response, the medical center has put in place what it described as “aggressive infection control practices” that include frequent hand-washing, additional laundering of clothes and linen and the use of protective equipment. Bergen Regional is also treating anyone believed to be at risk with creams and medicine as a preventive measure, Corrieri said.

The first signs of a possible outbreak came last July, when dozens of employees reported similar rashes. A union representing nurses and other staff was at first dissatisfied with the medical center’s response and complained to state and federal regulators.

“The concern then was that the cases weren’t investigated as part of a pattern but were treated as isolated cases,” said Jeanne Otersen, policy and political director for the Emerson-bases Health Professionals and Allied Employees.

Bergen Regional ended up paying a $3,000 fine in a settlement with the U.S. Labor Department’s Occupational Safety and Health Administration. In addition, inspectors from the state Department of Health issued the facility an “actual harm” deficiency, faulting operators for not following appropriate infection control procedures and ordering the facility to hire an independent expert.

Regulators and a union representative said this week they are satisfied with how Bergen Regional has handled this year’s outbreak.

“We believe they are following the new policies,” Otersen said.

Scabies is officially diagnosed through a biopsy test in which a sample of skin is scraped. Although only seven patients received confirmed diagnoses last summer, a state health department outbreak report completed in December listed 10 other “probable” cases among residents and seven “probable” cases among staff.

“A very hot summer of 90-plus-consecutive weather could have been a contributing factor” to the high number of overall reported rashes, most of which were determined to be non-contagious and of unknown origin, Corrieri said.

Bergen Regional is not the only health-care institution to have experienced a recent scabies outbreak, Corrieri said, pointing out that the state health deparment’s Communicable Disease Service sent an alert to facilities last fall, warning that numbers appeared to be on the rise.

In 2012, there were 40 total scabies outbreaks reported to the state health department, 30 of which occurred in nursing homes or long-term-care institutions a state health department spokesman confirmed. In the five years prior, the state received an average of only 11 outbreaks a year. An outbreak is defined as one or more laboratory confirmed cases, and at least one suspected case, within a four-week period.

As of this week, there have been 19 outbreaks reported to state health authorities this year, 15 in long-term-care settings, the spokesman said.

Given that Bergen Regional operates the largest nursing home in the state within its medical center, it’s not surprising that an outbreak in the region would find its way inside Bergen Regional’s doors, Corrieri said. “If there’s an increase in the community, then every health care institution in the community is at risk,” she said.